Gonorrhea with the wind - Dr. Dick

Gonorrhea with the wind

Dear Dr. Dick,
I've been hearing some water cooler gossip about gonorrhea going berserk. I heard there's a new strain that you can't cure with antibiotics. What do I need to do, aside from wearing a full-body condom when I P n' P?
-Worried for my Willie

Dear Willie,

I understand your fear. No one likes the thought of a "super bug"-- especially one that can spread through sex.

While gonorrhea hasn't gone bananas, there have been concerns about gonorrhea becoming harder to treat. As a result, providers now always treat gonorrhea with two different types antibiotics to ensure the patient gets cured, AND, to prevent drug resistance. Here in King County, there have been 25 cases of drug-resistant gonorrhea since February 2014. All of the cases have been in MSM (Men who have Sex with Men).

What's the big deal?? Untreated gonorrhea can cause serious and long-term health problems. Here's a little Gonorrhea 101:

Gonorrhea is a bacteria that spreads easily through anal and vaginal sex, and oral sex (including rimming). In MSM, it can infect the urethra, rectum, and throat.

Symptoms usually show up 2-7 days after a person gets exposed to the bacteria, but many people - especially guys with infections in the throat or rectum -- don't get symptoms. When people do get symptoms, they are:

• A "drip" (discharge) that comes out of the penis, vagina, and anus
• Pain or burning when you pee
• Itching around the urethra (where you pee from)
• Painful or swollen balls
• Irritation around the anus (hole)
• Bleeding and/or pain when you poop
• If gonorrhea is in the throat, it can feel like you have a sore throat


One of the best ways to prevent gonorrhea is to get tested. Guys who have sex with guys are encouraged to test for gonorrhea, chlamydia, syphilis, and HIV every 3 months--unless they're in a mutually monogamous relationship where both partners have been tested and know their statuses. At the least, test for these STDs once per year.

If you test positive for gonorrhea, connect with your medical provider right away to start treatment. It's important to take the antibiotics exactly as prescribed, and to finish the course of treatment. Don't take antibiotics that you buy online or on the street, or that aren't prescribed for you. Your sex partner(s) need to get treated too, so the bacteria doesn't keep passing back and forth. Keep it in your pants while you're taking the antibiotics---or use condoms if abstaining from sex isn't an option. Get tested again 3 months after you complete treatment for gonorrhea.

*If you are between regular STD tests, and think you have symptoms of gonorrhea, visit your medical provider right away!

Rubbers continue to be one of the most effective ways to prevent sexual bugs. Don't like "male" condoms? An insertive ("female") condom can be placed in the anus up to 8 hours before sex. Non-latex and less mess!

Untreated gonorrhea can increase your chances of getting or spreading HIV. Consider the following:

Guys who are HIV-negative and at high risk for getting HIV can take PrEP. How does it work? You take a pill once a day, every day, to lower your risk of getting HIV. It's important to keep in mind that PrEP alone won't stop you from getting infected with HIV.
It's strongly recommended that guys who take PrEP also do the following:
• Use condoms every time for anal and vaginal sex
• Talk to their partners about their HIV status and using protection
• Get tested regularly for STDs, and get treated if an STD pops up
• Get tested every 2-3 months for HIV
• Take their PrEP meds every day
• Use brand new needles and works every time they inject
TALK TO YOUR MEDICAL PROVIDER if you are interested in PrEP. For more info about PrEP, check out my article That Little Pill.

If you're negative for HIV, and think you might have come in contact with HIV through condomless sex, a condom break, or a needle stick, you might consider getting on PEP (Post-Exposure Prophylaxis). PEP can lower your chances of getting infected with HIV. How does it work? You take a 28-day course of HIV medication to decrease the chance that the virus will settle in your body.
If you feel you might have been exposed to HIV, go to the emergency room at Harborview within 24 hours of the exposure, to get a prescription for PEP. You can also see your primary care provider, if they can see you immediately. PEP works best when started right away, and will not be prescribed for you after 72 hours (3 days). For more info on PEP, check out my article Feelin' Peppy.
Let's hope that this will be a case of gonorrhea with the wind! Take care,

-Dr. Dick

Data and information source: Gonorrhea Health Advisory, Public Health - Seattle & King County, July 20, 2015 http://www.kingcounty.gov/healthservices/health/communicable/hiv/prevention/gonorrhea.aspx

« SMEAR CAMPAIGN!? | Dr. Dick Home | Pain in the Ass »